Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands,

[Emily]

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20776

Eurosurveillance, Volume 19, Issue 16, 24 April 2014
Surveillance and outbreak reports
Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands, 2012
G Ladbury ()1,2, S Ostendorf3, T Waegemaekers3, R van Binnendijk1, H Boot1, S Hahn?1

Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven,
European Programme for Intervention Epidemiology Training, European Centre for
Municipal Health Service Gelderland Midden, Arnhem, the Netherlands

Citation style for this article: Ladbury G, Ostendorf S, Waegemaekers T, van Binnendijk R, Boot H, Hahn? S. Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands, 2012 . Euro Surveill. 2014;19(16)ii=20776. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20776
Date of submission: 08 December 2013

We describe a mumps outbreak in a highly-vaccinated population attending a party at a youth club. In a retrospective cohort study with 60 of approximately 100 participants responding, vaccination status was verified for 58/59 respondents, of whom 54 were vaccinated twice and four once. The attack rate was 22% (13 cases, all vaccinated), with smoking at the party (risk ratio (RR) 3.1; 95% confidence interval (CI): 1.6?6.0, p=0.001) and age ≥21 years (RR 4.7; 95% CI: 2.1?10.2, p<0.0001) as risk factors for disease in the binominal regression analysis. Mild upper respiratory illness was also highly prevalent in those who did not meet the mumps case definition (n=46) after the party, suggesting that mumps virus infection may cause mild disease in vaccinated individuals. Our investigation adds to evidence that crowded social events and smoking may facilitate spread of mumps virus among vaccinated populations, with waning immunity playing a role. The suggestion that mumps virus infection in vaccinated individuals may manifest as mild upper respiratory illness could have implications for transmission and warrants further investigation.

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